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| Effect of different CO2 pneumoperitoneum pressure on cognitive function of elderly patients after general anesthesia laparoscopic surgery |
| LI Xia1 HE Wensheng1 CHEN Liang1 LI Yuanhai2▲ |
1.Department of Anesthesiology, the Second People′s Hospital of Hefei, Anhui Province, Hefei 230000, China;
2.Department of Anesthesiology, the First Affiliated Hospital of Anhui Medical University, Anhui Province, Hefei 230000, China |
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Abstract Objective To explore the influence of different CO2 pneumoperitoneum pressure on cognitive function of elderly patients after general anesthesia laparoscopic surgery. Methods From December 2017 to January 2019, 60 cases with elderly patients who undergoing general anesthesia laparoscopic surgery were selected in the Second People′s Hospital of Hefei. According to the pneumoperitoneum pressure, they were divided into low pressure group (6-8 mmHg), medium pressure group (9-11 mmHg), high pressure group (12-14 mmHg), with 20 cases in each group. The heart rate (HR), mean arterial pressure (MAP), arterial blood CO2 partial pressure (PaCO2) of three groups at before pneumoperitoneum, half an hour and one hour after pneumoperitoneum, half an hour after the end of pneumoperitoneum were compared; neuron specific enolase (NSE) and S100 β at ten minutes before anesthesia, end of operation, 6 h and 24 h after operation were compared; the mini mental state scale (MMSE) of three groups were evaluated at one day before surgery, 6 and 24 h after surgery. Results HR levels at half an hour and one hour after pneumoperitoneum in high pressure group were higher than those in low pressure group, with statistically significant differences (all P < 0.05). MAP levels at half an hour and one hour after pneumonperitoneum in middle and high pressure groups were higher than those in low pressure group, with statistically significant differences (all P < 0.05). The PaCO2 levels at half an hour and one hour after pneumoperitoneum in middle and high pressure groups were higher than those in low pressure group, and the PaCO2 levels at half an hour end of the pneumoperitoneum in high pressure group were higher than those in low pressure group, with statistically significant differences (all P < 0.05). The NSE protein levels at the end of operation and six hours after operation of high pressure groups were higher than those of low and middle pressure group, and middle pressure group was higher than low pressure group, with statistically significant differences (all P < 0.05). The S100β protein levels at the end of operation in middle and high pressure groups were higher than those in low pressure group and high pressure group was higher than middle pressure group, and the differences were statistically significant (all P < 0.05). MMSE scores of three groups were compared at different time points, and the differences were not statistically significant (all P > 0.05). Conclusion Different CO2 pneumoperitoneum pressure has no significant effect on the cognitive function of elderly patients after general anesthesia laparoscopic surgery, and hypobaric pressure may reduce the risk of postoperative cognitive dysfunction.
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